Nip This Tuck That

Here are some common questions and answers:

Q: I often read that it takes 10 days to recover from a face lift but I don’t know if that includes upper and lower blephs plus browlift, which people often have at the same time. I’d like to know how long to budget in a general way even as you need to add the disclaimer that everyone is different, we all heal at different rates. If it helps I am a 45 woman basically in good health, some asthma and allergies, of Caucaision and African-American descent.   A: I have performed Face Lifts for over 20 years and don’t perform Brow Lifts along with Full Face Lifts because of the area of tissue dissection that required: across the entire forehead, face and neck.  This leaves very little area for blood supply to heal the skin flaps along the lower section of the Face Lift.  I typically will perform the full Face Lift, Neck Lift with or without the Bleharoplasty (eyelid Surgery) and save the Browlift for another time at 6-12 months later.  This is safer than having a problem with healing after the Face Lift where a portion of the skin could die creating an unsightly large scar. Full Face Lift with Neck Lifts require patients stay in the Beverly Hills/Los Angeles area for a minimum of 10 days and the tissues will take 4-6 months for the swelling, lumps and bumps to resolve.  Depending on your particular case…how much tissue dissection, skin removal etc. is performed, the longer your recovery time.  Most patients are able to put on makeup and look at 1 month post-op.   Q:When is the pre operative surgical markings done for a face lift and blepharoplasty. It is before the surgery while you are awake and sitting up or after you are sedated and lying down? A: I have been performing Face Lifts for over 20 years and have taught Face Lift techniques to resident surgeons for quite a few years. The markings associated with a Face Lift could be done either way…with the patient sitting up which is the way I saw plastic and Cosmetic Surgeons do when I was training over 20 some years ago. I have always allowed my Face Lift patients to lay down on the O R table before I do the facial marking as I feel it allows them to relax more. IMO, if the results of a Face Lift are not what you desired, I really doubt the way in which things were marked had any real impact. It’s more important that the true aesthetics of the face are accentuated during any Face Lift technique. The aesthetics of beauty is the topic of my new book “What’s Your Number…the palmer code”. Q: Opinions on Stem Cell Facelift? Is the “stem cell facelift” hype or something worth looking into? I have seen wonderful before and after photos, but I have learned not to always trust them. Thank you for your input. A: Sadly, complete hype. Stem Cell Face Lifts are nothing more exotic than your own fat treated to isolate the naturally occurring stem cells within your fat which is then injected into your face like traditional fat transfer.  Stem Cell Face Lifts may plump up the face but there’s no evidence to support claims that these stem cells will magically rejuvenate your face. Stem Cell Face Lifts can’t:

• tighten the underlying SMAS muscle layer
• tighten or remove excess skin

Q: Would a Surgeon Refuse Me a Temple Lift for Being Too Young?

I am a 20 year old female. I realize that face lifts are intended for much older people, but I think a temple lift could help improve the overall look of my face by giving the outer corners of my eyes a subtle lift and slightly lifting my lower cheeks. I’ve used my fingers to gently elevate the skin in that area and I quite like the way it looks. I don’t think my age should be a big factor in determining whether or not I am a good candidate for this surgery.

A:

At 20 years old it’s unlikely that your eyebrows are low enough in position to warrant any type of Forehead Lift.  I would always reserve the right to change my opinion based on seeing you but in my 20 + years of performing Face and Forehead Lifts, I have not performed a Forehead Lift on anyone under 27 and any type of Face Lift on anyone under 32 years of age.

Q: Face Lift at 40 years old

If I’m in my 40’s, would it be alright to have a Face Lift instead of a filler like Perlane or Restylane? A: Your age is much less of a deciding factor than the signs of aging and the shape of your facial features.  If you have nasolabial folds, jowls and excess loose skin, fillers would be helpful in shaping the face but won’t and can’t remove excess skin or tighten the underlying SMAS muscle.  For that, you would need a Minimum Incision Face Lift or a larger, more invasive traditional Face Lift. Think of fillers like Radiesse, Perlane, Juvederm, Restylane and Sculptra as the least invasive and effective method of reversing facial aging.  Combined Minimum Incision Face Lift along with fillers as the next step and finally fillers with a more involved type Face Lift as the most extreme way to rejuvenate the face and neck.

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Information on Plastic and Cosmetic Surgery topics brought to you by Dr Francis Palmer , world renowned Beverly Hills Plastic and Cosmetic Surgeon voted one of the “world’s best” plastic and cosmetic surgeons.

Today’s news carries a story of Cindy who’s had a record 52 plastic and cosmetic surgeries. I recall media about Cindy, over the years both here and the UK (primarily), where she’s advocated this extreme amount of plastic surgery. Cindy received a stern talking to by Barbara Walters some years back about too much plastic surgery, during one of her US TV appearances and that must be at a point when she had fewer surgeries than the 52 being reported today. Is she a Celebrity because she’s had plastic surgery? It would appear so.

The question isn’t whether it’s right or wrong for her to have this exaggerated number of plastic and cosmetic surgeries ranging from Face Lifts, to Breast Implants, Cheek Implants, Chin Implant, Rhinoplasty and Eyelid Surgery….but rather should this be something that others should emulate? To this, I say a resounding NO! 52 surgeries seems ridiculous, outrageous and highlights some other need that is being met with constantly going under the knife. I’m not convinced that she looks good or better, so I’m not sure what the point of 52 surgeries would have been. From a video on today’s media, she has her hair hiding the front of both ears…what do the scars there look like after multiple Face Lifts and her right side of her mouth seems not to move as well as the left which could indicate nerve damage from one or more of these surgeries.

If we were to use The Palmer Code to calculate her Face Number, would that Number be higher in her before or after photos? ‘m guessing the before pictures would score higher, but you do the calculations yourself and formulate your own opinion. More is not always better and with plastic and cosmetic surgery at the World’s Best level, there is no substitution for sound aesthetic judgment and this would not dictate 52 surgeries, not ever IMHO. The media does consumers a disservice running these pieces with a disclaimer “please don’t try this yourself”.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

The are so many sources today all claiming to give you information about plastic and cosmetic surgeon including a list of the top, best plastic and cosmetic surgeons that it’s easy to become overwhelmed in your search. How are you supposed to know which source you can trust? Here’s a brief article that I wrote on How to Choose your Plastic and Cosmetic Surgeon that would apply for someone seeking any type of plastic and cosmetic surgery or procedure including Botox, Dysport, Eyelid Surgery, Rhinoplasty, Forehead Lift, Face Lifts, Cheek Implants, Chin Implant, Breast Implants for Augmentation and Enhancement, Lip Augmentation, Perlane, Radiesse, Restylane, Juvederm or Sculptra.

Plastic and Cosmetic Surgery is the art of aesthetically enhancing the physical form. When properly performed, it can dramatically improve one’s appearance, restoring natural and youthful beauty.

A skilled plastic surgeon can help you achieve the look you’ve always desired through a combination of sound aesthetic judgment and surgical expertise that takes years to cull. Quality plastic surgery is “invisible”-it helps you look younger and more attractive, without appearing obvious or artificial. However, aesthetic vision and surgical skill vary among surgeons-so be sure that you are in the hands of a surgeon that is aesthetically gifted, highly competent and extremely well experienced.

Follow these four simple-common sense steps when selecting your plastic and cosmetic surgeon.

#1. First and foremost, listen to the aesthetic judgment of the surgeon. Does it sound like something that would enhance your appearance? Proper beauty aesthetics are easy to comprehend when properly explained. If it sounds reasonable to you, then proceed to step two. If it doesn’t sound right to you…..get another opinion. There is simply no substitute for sound aesthetic judgment! You may wish to read my new book on this subject “What’s Your Number…the palmer code.” **Available at Amazon.com

#2. Ask yourself if the surgeon has the experience to do what he/she is suggesting. Don’t be afraid to ask the surgeon-”how many times have you performed this procedure?” Most important of all-be sure to see real before and after photographs of patients who have undergone the same procedure. Do not settle for computer simulations! The computer will not be altering your looks—-the surgeon will! This is extremely important because, there is no substitute for experience! If you are satisfied, then proceed to step three-if you are not sure, then get another opinion!

#3. Once the first two steps have been met, you can factor in the price. Prior to this you’re not certain which procedure is right for you-therefore the price should be irrelevant. Step three is a point where you can be fairly comfortable with the level of surgical competence and overall satisfaction, so you may want to compare costs. Minor differences in costs may reflect such things as, how much of the finishing stitches does the surgeon do-or does the assistant complete this portion of the procedure. How well are the incisions hidden and how often will you have follow-up visits with the surgeon. There are reasons for price differences-be sure that you understand exactly what you are/are not getting! You may opt to pay the higher price for more personalized care! You can continue on to the fourth and final step.

#4. This is more of an intuitive step than the previous three. Here you may want to factor in variables like the board certification of the surgeon. Does he/she carry an impressive reputation in the community or carry a university teaching affiliation? How do you feel about the surgeon and the office staff? Follow your gut instincts—–they will serve you well!

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
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World’s Best Rhinoplasty Beverly Hills Style Part Three:

Let’s continue with our series on Rhinoplasty with some specific areas where the nose can be improved. The major anatomical areas of the nose are:

The Nasal Tip:

When people speak about the nose being long or short, in length, they are really describing the angle of rotation of the nasal tip as it meets the upper lip. In long noses, the tip is under rotated from the ideal 105-115 degrees with the later more appropriate for women rather than men. When the tip angle of rotation is 90 degrees or less, the tip is seen as hanging…almost like you could touch it with your tongue. The opposite is also true when the tip is over rotated with and angle greater than 115 degrees giving the nose a short, “pig nose” look.

Rhinoplasty can change the angle of rotation closer to the ideal utilizing various surgical techniques from onlay cartilage tip grafts to trimming the anterior septal angle. If there is an excess of tip cartilage, this cartilage can be re-shaped or reduced to achieve a more streamlined appearance. Tip cartilage shape, symmetry and rotation are the major issues that need to be assessed before a specific and effective Rhinoplasty plan can be formulated.

The upper lateral Cartilages:

The area immediately adjacent and above the nasal tip is referred to as the Supratip and consists of the upper lateral cartilages that combine in the mid line with the superior (upper aspect) of the nasal septum to form the nasal dorsum or bridge. This area can be indented (concave), flat or Convex (stick out) and there can be quite a bit of asymmetry between the two sides of the nose in this area. In addition, the nasal bridge can have a bump, depression or be crooked to one or both sides resulting in an overall C or S nasal shape. The cartilage in this area can be shaped and trimmed for added symmetry and shape. During Rhinoplasty, the nasal bridge can be thinned horizontally and the vertical height can be either reduced or increased to address the specific flaw.

The nasal bones:

The next area of the nose is made up or the right and left nasal bones that join the bony portion, of the nasal septum, in the mid line to create the uppermost area of the nose and nasal bridge. As the cartilage area below it, the nasal bones can be wide, asymmetric, high or low to the face. The bones can be rasped using a nasal rasp to reduce and shape the bone or the bones can be surgically broken and fractured to move their alignment (called osteotomies). There are numerous types and ways to create nasal fractures but I prefer the lateral method where the nasal bones are fractured where they attach to the face. The nasal bones should be splinted for 1 week with a nasal cast and our patients are advised to avoid physical contact that may shift the nasal bones for 1 month post Rhinoplasty. We do not use nasal packing for Rhinoplasty even when the nasal bones are fractured except in cases where deviations in the nasal septum have been removed….in which case a small piece of telfa is placed in each nostril overnight and removed the next day during the first post op Rhinoplasty visit.

The nasal septum (inside the nose and separates right from left nasal cavity):

The nasal septum has little effect on the outside shape of the nose except in extreme cases of septal deviation leading to loss of structural support to the overlying tip, upper lateral cartilages and nasal bones. The most common septal manipulation, in my practice, is the resection of the anterior septal angle to allow rotation of the nasal tip. Next most common manipulation is to remove deviated portions of the septum to improve air flow in the nose. It is normal to have cycling and reduced airflow through one side of the nose alternating to the other side every 90 minutes or so…but becomes a problem when one side of the nasal airway is always reduced or blocked. In these instances a septoplasty to remove the hard cartilage or bone obstruction can increase the airway space. Septoplasty can be carried out alone or as part of a Rhinoplasty.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

Thank You cards, letters, E-mails and Patient reviews from the best possible source…our own patients.

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How To Choose Your Plastic and Cosmetic Surgeon

One of the ways that you can ensure that you get the World’s best Rhinoplasty result is to have a thorough nasal evaluation with a highly skilled, well trained and experienced Rhinoplasty surgeon. So before you listen to you friends who all seem to believe that their Plastic and Cosmetic Surgeon is the best Rhinoplasty Surgeon in the world (which obviously is statistically impossible as this distinction, IMO, fits a handful of Rhinoplasty Surgeons in the entire world)…it’s in your best interest to plan how you can get an accurate evaluation of your nose and how a Rhinoplasty may improve its appearance.

This should be the first and foremost thing on your Rhinoplasty agenda. Here’s the tough part….this will most likely mean that you can’t, won’t and are unlikely to be able to log onto some online chat room, forum or message board post your question and get the appropriate answers from lay people who have never, ever performed a Rhinoplasty nor received formal plastic and cosmetic surgery training to do so. Just because someone has had multiple Rhinoplasties themselves, or has acted as a lay consultant for Rhinoplasty surgeons does in no way shape or form mean that they have the technical training, expertise or surgical knowledge to evaluate your nose for Rhinoplasty. They have never done one! In surgical training there is an old saying: “you could observe a thousand surgeries (including Rhinoplasty) but you will never know how to perform the surgery until you actually do one.”

I have been performing Rhinoplasty for close to 25 years and have taught Rhinoplasty to surgeons in training for many years. IMO it takes years and hundreds of Rhinoplasties in order to become highly skilled and proficient in this the most technically difficult of all plastic and cosmetic surgery procedures. This means that if a plastic and cosmetic surgeon has the propensity to become highly skilled at Rhinoplasty…it will most likely take him or her a minimum of 7-10 years in practice to do the number of Rhinoplasties required to achieve that level of experience. Not exactly the sort of thing Susie from Idaho on a plastic surgery forum is likely ever to achieve..and you should realize that from the start. Be wary of information on the internet from lay people or those who’s identity and knowledge base are not visible or revealed.

So when you are considering Rhinoplasty, you should do some work locating the best possible Rhinoplasty Surgeons for consultation. Pay for the consultations and think of this as money well spent learning about your nose and what can be done to make it more attractive. Free consultations may result in over selling you on a procedure or surgery. If you need to travel to Beverly Hills, The US or somewhere outside your country or city to see these plastic and cosmetic surgeons…do so. You will need to see the best..to get the best. There are no miracle answers or bargain basement prices. Going that route may very well result in you having one or more Revision Rhinoplasties down the line.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
What’s Your Number…the palmer code book

Thank You cards, letters and E-mails from our Patients

The world’s Best (Top) Rhinoplasty is one that creates a natural, refined and aesthetically attractive nose. For over 20 years, I have performed Rhinoplasty Nasal Surgery on all types of noses…some large, wide, small, short, long, crooked, asymmetric and those with telltale signs of having had previous Rhinoplasty Surgery elsewhere. All of these many scores of noses may have started out with a different look but what they all shared in common was my sense of aesthetic goals for each and every nose. No matter what you nose looks like before your Rhinoplasty, the primary goal must remain to create a natural looking, relatively symmetric, aesthetically attractive nose that fits your own face. The last point is important because if your a rugged looking male with a wide face…your nose should not end up thin with an upturned tip (often referred to as being short) or your nose will look odd on your face. Similarly if you’re a petite woman you don’t want your nose to appear overly wide or long as this won’t compliment how attractive your nose or face is perceived.

When you think that you may be interested in nasal refinement through Rhinoplasty be sure to do the following:

1. Learn the basic beauty aesthetics of the nose and how it relates to the face as outlined in my new book “What’s Your Number….the palmer code

2. Be realistic in the type of result that a Rhinoplasty can achieve. This will often need to be determined during consultation with a well trained, highly experienced Rhinoplasty Surgeon. “How to Choose Your Plastic Surgeon.”

3. Have Consultations with 2 or 3 top, best Rhinoplasty Surgeons based on experience and pay for the consults. Free consults are typically offered by less experienced Surgeons offices and they may concentrate more on selling surgery than educating you about what would look good on your nose and face.

4. Do not look for bargain priced Rhinoplasty. The Best, Top Rhinoplasty Surgeons do not do cut-rate priced Rhinoplasties. Expect to pay in the upper range of Rhinoplasty costs to get the best. There are no secret deals, bargains or special offers…ever. Some of the most difficult Revision Rhinoplasties that I have had to perform where just such instances. The patient got a too good to be true deal…and had to pay me top dollar for their Revision Rhinoplasty.

I understand that you may not have one of the World’s Best Rhinoplasty Surgeons in your city, state or even country and yes, I am advocating that you make the effort to travel and have your Rhinoplasty in such instances in the city the top Rhinoplasty Surgeon operates whether it be in Beverly Hills or elsewhere. I further realize that in today’s society where instant gratification and convenience is everywhere that traveling to Beverly Hills seems an extreme inconvenience but “it is what it is.” If the best Rhinoplasty Surgeon is there then you should go there for your Rhinoplasty. Rhinoplasty is the most technically challenging of all the plastic and cosmetic surgery procedures, IMHO and takes thousands of Rhinoplasties performed and a minimum of 7-10 years experience before a plastic and cosmetic surgeon is truly proficient at performing Rhinoplasty. In Revision Rhinoplasty, the difficulty is a quantum level higher and requires even more experience to achieve the desired aesthetic result. Celebrities, at least some of them get the best, top plastic and cosmetic surgeons to do their plastic and cosmetic surgery procedures including Rhinoplasty, so why can’t you?

Next time Part Two: Fundamental Parts of the Nose.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

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Patient reviews and testimonials from letters, thank you cards and e-mails that our own patients sent to us.

World Renowned Beverly Hills Plastic and Cosmetic Surgeon, Dr Francis Palmer, voted one of the “World’s Best” plastic and cosmetic surgeons describes his Palmer Celebrity Face Lift that offers smaller incisions, less bruising/swelling and associated downtime than traditional Face Lifts.

The Palmer Celebrity Face Lift, featured on ABC’s “The View” can make you look more naturally attractive, take off up to 15 years all in 90 minutes or less with or without general anesthesia. The secret lies with it’s creator, Dr Francis Palmer that Tatler Magazine named “one of the World’s Best” Plastic and Cosmetic Surgeons for his pioneering work in Face Lift techniques that shape the face in an attractive manner…avoiding the pulled, wind swept or upturned mouth joker look.

The Palmer Celebrity Lift is the next generation Face Lift that offers the following:

1. Much smaller, well camouflaged incisions that are 1/4 the length of more traditional Face Lift incisions.
2. Incisions do not go into scalp so hair loss is not experienced from incisions within the hair as may occur with
traditional Face Lifts, including some S-lifts, Mid Face Lifts and others.
3. Less invasive… The Palmer Celebrity Lift is a highly focused yet smaller area of tissue
dissection resulting in less area within which bruising and swelling can occur compared to traditional Face Lifts.
This results in less bruising, swelling and recovery time that can be measured in hours and days instead of weeks
and months as is the case with more invasive traditional Face Lifts.
4. Patients can fly home to Europe, Asia, the Middle East and across the US in as little as 3 days following
The Palmer Celebrity Face Lift versus 7-10 days with traditional Face Lifts.
5. The Palmer Celebrity Face Lift undermines, lifts, elevates and sutures the underlying SMAS
layer instead of merely lifting or folding the SMAS with sutures or barbed threads that must rely on keeping their
two-point fixation intact for the SMAS tyo stay lifted….should the threads or sutures come loose…the SMAS will
simply unfold and go back to its sagged position. This is why Dr Palmer does not use or recommend any type of
suture/thread suspension face Lift procedure. The Face Lift must, in Dr Palmer’s opinion, dissection, trim, lift
and re-suture the SMAS (muscle) layer for the effects of the Face Lift to last.
6. The Palmer Celebrity Face Lift combines SMAS tightening with excess skin and fat removal
combined with shaping of the cheeks, chin and jaw using either Cheek Implants, Chin Implants or fillers like Perlane, Radiesse, Sculptra, Restylane, Juvederm, Botox or Dysport. Just how the cheeks, chin, jaw and the Lips are shaped are based on Dr Palmer’s new book on the aesthetics of what makes us beautiful “What’s Your Number…the palmer code” available at Amazon.com Of course other plastic and cosmetic surgery procedures like Breast Augmentation with Breast Implants, Rhinoplasty, Eyelid Surgery, Brow Lifts and even Tummy Tucks can be done at the same time.
7. Because The Palmer Celebrity Face Lift is designed to do all the above….it can be performed under local, IV sedation or a general anesthesia in 90 minutes or less.

If you’re looking to be more naturally beautiful, as a woman or more ruggedly handsome as a man…The Palmer Celebrity Face Lift might just be the answer. You may have to travel to see Dr Francis Palmer in Beverly Hills but the journey is a small price to pay for the expertise, quality and impeccable aesthetic judgment that you will receive. All Plastic and Cosmetic Surgeons are NOT created equal… How To Choose Your Plastic and Cosmetic Surgeon.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”
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Dr Palmer Media Continued
Patient Testimonials

Face Lifts like our “Palmer Celebrity Lift” (featured on ABC’s hit TV show “The View”), Breast Augmentation with Silicone or Saline Breast Implants, Rhinoplasty (Nasal Surgery), Blepharoplasty (Eyelid Surgery), Cheek Implants, Chin Implant, Lip Augmentation with Alloderm or silicone implants, Tummy Tuck and various types of body lifts…are all great ways for you to improve on the way you look. However, these plastic and cosmetic surgeries have downtime and if you’re looking for a way to look great right now, today you simply can’t beat fillers and wrinkle softening injections. It’s what many Celebrities do before Oscar, Emmy’s, Grammy, People’s Choice Awards or anytime they want to look star quality beautiful….and these quick, easy fixes are not just for women anymore as more and more men are discovering fillers and wrinkle softening injections as a means to make them appear more angular, handsome and youthful.

If you’re considering fillers and wrinkle softening treatments here are a few suggestions for you to consider:

Botox, Dysport, Radiesse, Perlane, Sculptra and Juvederm are the same no matter what plastic and cosmetic surgeon or dermatologist you choose to administer the treatment. There is no inherent magic in the fillers or neourotoxins (Botox, Dysport) themselves…these materials don’t possess smart technology to ensure that they are placed in the right just the right amount to give you the very best aesthetic results. If yu think about this logically, it makes sense. Using Botox, Dysport, Perlane, Radiesse, Juvederm or Sculptra is an art in and of itself. It requires a level of skill, training and experience, so do not use price as your determining factor of where and by whom you receive these treatments. If you want the best, top results you’ll have to pay a reasonable fee. Period. It’s a great idea for you to learn the basic aesthetic principles that will make you more attractive which I have done for you in my new book “What’s Your Number..the palmer code.”“>”What’s Your Number…the palmer code” available at Amazon.com.

Here are some uses, we have for the neurotoxins and various fillers: These procedures are done as an office visit in 10-15 minutes with minimal discomfort or downtime. Patients fly here from all over the world for these treatments and are allowed to fly home the same day.

1. Reduce unwanted wrinkles of the forehead, glabella (between the brows), Crow’s Feet and around the lips or mouth using either Botox or Dysport. I like to have my patients receive a full treatment as a booster 1 month from the initial treatment for added effect. Once that’s done, the Botox or Dysport treatments can be done every 4-6 months to maintain the results.

2. Elevate the corners of the mouth or eyebrows. Botox or Dysport can be used to elevate the corners of the mouth or the tail of the eyebrows.

3. Botox and Dysport can be used to reduce unwanted areas of enlarged facial muscles around the mouth or nose (“nasal srunching”).

4. Shape the Cheeks, Chin or Jawline using fillers like Perlane or Radiesse. Allows your face to look more youthful, feminine and naturally beautiful as a woman or more angular and ruggedly handsome if you’re a man. All in 10-15 minutes with the results lasting about 6 -12 months depending on which filler is used. We do use Cheek and Chin Implants to permanently enhance the Cheeks and Chin for men and women but I have been hesitant over the past 20+ years as a Beverly Hills Plastic and Cosmetic Surgeon to use Mandible (Jaw) implants because of he risks and possible complication associated with those implants, so the fillers offer a safe and viable alternative for people who require jaw enhancement IMHO. Because Radiesse is a thicker molecule there’s a bit more swelling and lumpiness with this than after Perlane IMO so we prefer to use Perlane the first time our patients have fillers to shape the face and in all cases where our patients have an important event, like a red carpet, appearance that night or the following day.

5. Plump up the lips, using the proper aesthetic proportion outlined in my book, using Juvederm.

6. Fill out the Nasolabial (NLF) folds or Marionette Lines using a variety of fillers. Juvederm for superficial (folds not too deep), Perlane and Sculptra for deeper folds. Radiesse can show as a stiff line within the fatty tissues in some patients and should be sued only when the folds are very deep IMO.

7. Sculptra is excellent to fill out hollows or depressions in the face, temples or hands. Sculptra is a staged type of treatment where the patient receives an initial treatment and then is treated again in approximately 8 weeks for a full correction. Some times a third treatment is required. The good news is that Sculptra, unlike the other fillers, causes your body to make its own collagen and the results last up to 2 years. I do not use Sculptra to create shape in the cheeks, chin and jawline as I feel the larger molecules of Perlane and Radiesse are better adapted for that purpose.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

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Patient Testimonials

Radiesse, Perlane and Juvederm are just a few of the fillers that can be injected to shape the face and lips but what makes the outcome, of these fillers, the “best” or “top”?

I think everyone would answer “the results” obtained by using the fillers. More specifically, this means, the ultimate shape of the face and lips after the Radiesse, Perlane or Juvederm was injected.

In order to obtain the desired, aesthetic shape the plastic and cosmetic surgeon has to know what aesthetic shape is ideally attractive in a nam or a woman. Yes, they are different and no, we as plastic and cosmetic surgeons are not taught, during training, what is or is not a beautiful face because no-one until now has even defined what makes a face beautiful. Silly as it may seem, millions of people all over the world are undergoing plastic and cosmetic surgery procedures and treatments, including fillers to shape the face and lips without the understanding of what they are trying to accomplish…which is a more attractive face! Worse yet, the plastic and cosmetic surgeon may not have understanding of the same issue.

Fillers like Radiesse, Perlane and Juvederm Ultra XC are fantastic at augmenting and shaping the cheeks, chin, jawline and even the nose but if placed in the wrong place or in the wrong amount can create a mis-shapen face. Juvederm in the lips can give a beautiful, soft pouty look to the lips if done correctly but when it’s not…the result can be “fish-mouth” which is hardly attractive. So, the question remains: “how do you get the best, top results from your fillers?” Simple, choose a plastic and cosmetic surgeon that can show you he/she understands the aesthetics of facial beauty as outined in my new book which defines the subject “What’s Your Number….the palmer code”

If you want the “Best”, “Top” results, don’t have Rhinoplasty, Face Lift, Eyelid surgery, Rhinoplasty, Cheek Implants, Chin Implant, Breast Augmentation with Implants, Botox, Radiesse, Perlane, Juvederm or any other plastic and cosmetic surgery or procedure until you know what does and does not make your face more attractive.

Trust me, buying this book is the best money you’ll ever spend on yourself. The only way to get the “best”, “top” results is to follow the principles, of “What’s Your Number” and “The Palmer Code” describing beauty and its component parts. That’s what we have done in Beverly Hills (Los Angeles) and in London over and over for more than 2 decades. If a celebrity looks good after plastic and cosmetic surgery, these principles were follwed. When celebrity plastic surgery looks hideous, these principles were ignored.

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”

Rhinoplasty and Revision Rhinoplasty advice from Beverly Hills Plastic and Cosmetic Surgeon, Dr Francis Palmer, voted “One of the World’s Best” Plastic and Cosmetic Surgeons.

I’ve been receiving more and more e-mails and photos of potential fisrt-time Rhinoplasty as well as Revision Rhinoplasty patients from all over the world. The latest several were from Taiwan, Singapore, Shanghai, London, India, London and Brazil. When explaining the aspects of their noses that can and should be considered for improvement during a Rhinoplasty, I have always found it useful, to the patient, to teach them a little bit about the nasal anatomy. It’s also helpful to let Rhinoplasty patients understand the post op healing so they understand what is and isn’t typical.

For example, one patient e-mailed my office photos for me to review for a possible Revision Rhinoplasty that was performed in Europe by another plastic and cosmetic surgeon. The patient had some questions about what was causing the irregularities, of her nose, at the 10 month post-op Rhinoplasty stage. From the photos, of her nose, it seemed very likely that she had what is called an “open roof” deformity with an incomplete fracture of one side of her nasal bone. The remedy, in that particular case, is repeat fracture of that nasal bone during a Revision Rhinoplasty. This information, whether acted upon by the patient or not, put an end to uncertainty and confusion about why her nose looked the way that it did.

I have mentioned this many times on this blog…Rhinoplasty is the most technically difficult plastic and cosmetic surgery procedure performed and Revision Rhinoplasty is even a quantum level more difficult than that. Training, experience and aesthetic judgement are the three essential keys for your Rhinoplasty Plastic and Cosmetic Surgeon to possess…do not settle for anything less. Get the very best, top plastic and cosmetic surgeon, even the world’s best. Here’s a simple 4-step guide on “How to Choose Your Plastic and Cosmetic Surgeon.”

Dr Francis Palmer
Beverly Hills Plastic and Cosmetic Surgery
“What’s Your Number..the palmer code.”
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